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APPLICATI�1 FOR CONSTRUCI�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 �—•- <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN6 ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS /�v� ���� <br /> OWNEP MI.KAppPE55 CILY 1V PNONE <br /> ./�P12L.�A.:�1� PCY'�'EFF/!E2 C-ti���( 9R'a7/ 4�i• 2�i2•�320 <br /> rcHu�r Mu��ooacss cirr rw Aro�a <br /> u�cnrtccra+ocsn,r¢n uu�s�� �a*� :�� rranc <br /> GENER4CON�PACIOR AIAILACpP(55 CI1Y IM AqNE $f�'[lY_CNSf• <br /> Rnm ��r3_�PrCE►.7F�_�1��� Fi�FbF�R�RX� 4e53�fi9%�� QL(AUL�ZL,-t� <br /> MECHnIII KCIX�INAL10fl \UiLI.Wf2.} Ci1Y ZIP ThqNC SG1ClKO15E• <br /> 1'LUM9111uCC111111LIO11 YA�LAOJPCS.'� CIiY IM PM'If1E 5(Al[LIC[115C• <br /> co��w�crrn�ccorxaa HEATINGSYSTEM: + 'ELECTRIC ❑ <br /> R <br /> ossenmcvro�e.rvosowncroor+currvav�o eoHunvcnsw�umanaara � <br /> -,� r,��n � rra�ux <br /> '� � <br /> �_tl/��F�-LSVQ.LCYI� I I HEREBY CERTIFY TI:�T I HAYE READ AND EXAMINED TMIS <br /> VK�SPFD �� � APPLICATION AND NNOW TME SAME TO BE TRUE AND CORRECT.ALL <br /> mroroseovse o�nu�mwn PPOVISIONS OF LAWS AND ORDINANCES GOVERNING iM15 TYPE OF <br /> WORN WILI BE COMPLIED WITH WHETMER SPECIFIED HEREIN OR <br /> uouocw vtqvur vnorcAtt�s?'i�awHectowautuatwocowcsi NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOi OIOCF 7aG �p�p�R� nIV ICI AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT�ON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTMORIZED BY THE <br /> OWNER OF iHIS PROPERTV TO PEHFORM TNE WORK FOR WMICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> r�acurexio r+u+mEn CONTRACTORS LAW 1027 RCW AND'196.200 WAC. <br /> cor�sinuciroH�ou�iu+ocrt�oor+css.rzicvrovcr�uuecn X � f'7 S Jl1/j/ �Q_�1CYl) <br /> S�cH++unF o�re <br /> CIiY BUSMESS lIC[NSE NJ <br /> PLUMBING MECMANICIIL <br /> NO. tYPE OF FIXTUflE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE _ <br /> WATER CLOSET�TOILET� A�C—AMNDLG UNITS <br /> BATMTUB FORCED AIR SVSTEMS <br /> LAVATpqY pYqSH BASIN� HEAT PUI.IP <br /> SHOWER UNIT HEATERS <br /> NITCHEN SINN 8 DISP CIOTMES ORVERS <br /> DISHWASHER RANGE MOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTMES\YASH'R WOO�STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING� <br /> DRINNWG FOUNTAW FIREPLACE INSEFT pVOOD BURNING) <br /> FLOOR DFAI4 GAS FIREPLACE <br /> pACNFLOIYPPEVENTERS GAS RANGE <br /> SINK�SER`110E—�AR.ETC.� GAS PIPING i <br /> E%MAUSTFAN <br /> SUOTOTAL 5 SU�TOTAL 5 <br /> PEflhllT 5 PERh71T 5 <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> lNONTSUO�CR BGq5E19ACM Si0C5E1BECR 1'UN�PCCRM1JM�Ii iEE PK[IVilq <br /> (l � �/ <br /> usczc�+e io*�ac� onc�Htsirc FEES VALUATION FEE <br /> ovcs n�ro owmva <br /> ��E�cr�ruu�t.iaH r+oorowxwnu s¢[oroioc�i <br /> unns cwuomc <br /> pCf.uvu6Y HOC95iCe6 OCN�u11lOLD O�SEM(N! 4ECNANCN <br /> GNOIIV <br /> mcs ❑r+o <br /> Fl1IESPPMxLCPPWD PGSON dC0�1qN4PlANCN6N <br /> 0➢�EP � <br /> iiREAU1iMPEOD flE�50N <br /> SI�tE&IilDnq SUPCIUUG[ <br /> ireeorcoHst riuusemnwmer CITYOFEVERETT �e���+'��s <br /> LOCALSAIES <br /> ���� TA%CODE IS 3105 TO7AL <br />